Dear Murphy:
From what I understand, being in the Wounded Warrior program allows the Soldier to expedite their claim with SSDI.
I do not believe that the SSDI people can deny you your claim based solely on the fact that you are NOT in the in Wounded Warrior program. Were that the case, then there would be many injured civilians denied, too. So I don't think your not being in the AW2 program is a sole disqualifier.
In my case, I DID NOT apply for SSDI through the SFAC Wounded Warrior Section at Fort Lewis because I was already in the CB-WTU program, and living at my Home of Record in Portland, Oregon. I live 135 miles one-way from Ft. Lewis, WA. I did NOT apply on-line as Soldiers
can do today, as I applied for SSDI before that access site became available. I went the traditional way - I walked into my local Social Security office, in uniform, and sat down in the office cube with the intake clerk.
What I'm getting at is this: Servicemembers can now apply on-line and I hear it's faster. They can also use the SFAC at the Wounded Warrior locations, and they can expedite you along these days. But since neither one was available to me at the time I opened up my claim, I had to go the traditional way. And it was a royal pain in the A$$ process.
Below is the POMS DI 10505.023 information copied and pasted below that I took directly from the SSA web site.
Now having said all this, I was still denied my SSDI!!! Twice in fact, I was denied. I was initially denied and I appealed. The second appeal was denied, too. So, I finally had to hire an SSDI lawyer and go to the SSDI Judge for a hearing on the third appeal. EVERY TIME I WAS DENIED MY CLAIM FOR SSDI, I
DID NOT RESTART OR RE-APPLY MY APPLICATION.
I CONTINUED TO APPEAL THE ORIGINAL CLAIM. By doing so, this kept the original clock ticking on my original date of my having opened up my claim. In my case, and for my stiuation, this was the best thing I did for myself, though I did not know this at the time.
I finally won my original claim at the third level of appeal with the SSDI Judge. Why I didn't win my claim prior to that I'll never know, as nothing was any different from the first appeal on up in terms of evidence. Maybe I'm being cynical here, but I think the folks down below the Judge/Court/third level deny, deny, deny - almost regardless. Unless you're at death's door that is - and then maybe they'll approve. At least, that's what happened to me in my Social Security Regional area of the country.
So, my having been denied twice by letter, with the second denial letter stating that if I was to appeal again, I had to go to a formal hearing with the SSDI Judge, forced me to have to go and hire a lawyer to represent me! If this happens to you, and you have to appeal to a Court Judge, go get yourself a lawyer who specializes in SSDI law. I found a local law firm in my city that handled these type of cases with a long and excellent track record, so I used a local firm - as opposed to a nationally advertised firm you see on TV.
I gave the lawyer all my paper medical records, psych records (three binders worth), and they scanned the parts they needed for my case and put them on a CD for me, too. This CD is a compilation of records on me that was tabulated according to how the Court wants things tabulated, and were the documents used to substantiate my claim to the SSDI Judge. Be sure to ask for a copy of this CD and keep one for yourself as it might come in handy sometime later on.
At this third level of appeal, my lawyer used some other SSDI directive to get me to the front of the appeals line with the Court. In my region, we have an almost 2 year wait list for the SSDI appeals Court. So because I was in the Wounded Warrior program, I only had to wait 6 months to get my turn at Court.
From the time I opened up my claim, to the time I was finally approved took 22 months! I got back paid from DEC 2007 to JUL 2010.
You DO NOT pay the lawyer up front. IF they think you have a case that is winable, then they get paid out of your back pay when you win. No win - no collect pay. The maximum they can get paid is either a set maximum percentage of your award, or, a maximum ceiling amount, plus miscellaneous (postage, printing costs) as set forth by law. So they can't gouge the hell out of your retro check. In the end, my lawyer collected about 17% of my award amount (retro check) - a small price to pay when other types of lawyers in other types of litigation cases can and do charge 33% plus.
So Murphy, hopefully you'll get approved for SSDI before you hit the third appeal. Many Servicmembers are getting approved earlier now than what it used to be. I hope this happens for you. I know of a case at Fort Lewis where it only took 4 months from start to finish where that Soldier got approved. And they didn't have to pay lawyer fees out of their retro award either. Must be nice. Sure wish this would have happened in my case, but it didn't.
So here's the POMS I made reference about earlier. Read it through as it applies to you.
Good luck and keep us posted.
Expiring minds wanna know!
v/r,
nwlivewire
DI 10505.023 Military Service
A. General
A person in the military service who is being treated for a severe impairment usually continues to receive full pay. Therefore, for substantial gainful activity (SGA) purposes, it is not appropriate to evaluate his or her work activity based on the amount of pay received. Instead, it is generally necessary to use nonmonetary SGA criteria in assessing the work activity of a service member receiving treatment at a military hospital or working in a designated therapy program or on limited duty. That is, the adjudicator must compare the activity with similar work in the civilian work force and determine its reasonable worth. See the “NOTE” for evaluating the work activity of a Title II disability beneficiary if the exemption of work activity provision in
DI 10505.020D. applies.
Severely impaired service members may, for example, be placed on limited duty status and put to work in a hospital, office, mailroom, laboratory, or the like. The controlling factor in these cases is an objective evaluation of the work activity itself, and not the service member's duty status, or whether or not a formal therapy program is involved. The fact that a therapy program or limited duty status is involved suggests that special subsidies or conditions may exist (see
DI 10505.010). This requires that the adjudicator consider the real value of the work effort within the military setting and then equate its value to similar work in a nonmilitary setting.
NOTE: Under the exemption of work activity provision described in
DI 10505.020D., the activities engaged in by a Title II disability beneficiary in work performed after he/she has received Title II disability benefits for 24 months, may not be used as evidence that the individual’s disability has ceased. However, the work activities engaged in by the beneficiary may be used as evidence when determining if disability has ceased if they show that the beneficiary is not engaged in SGA. Therefore, if application of the evaluation criteria in this subsection A. establishes that the work is not SGA, determine that the work does not show that the beneficiary is able to engage in SGA in a case in which the exemption of work activity provision applies. Otherwise, determine the beneficiary’s countable earnings and then apply the guides in
DI 10505.020A. or in
DI 10505.020B. to determine if the beneficiary is engaged in SGA for disability cessation purposes. Work performed in a therapy program or while on limited duty by a service member receiving treatment for a severe impairment generally suggests that the work is performed under special conditions, therefore pay special attention to considering only that part of the beneficiary’s earnings which are directly related to his or her own productivity when determining countable earnings. Compare the services performed in a military setting with like services performed in the civilian work force to determine the value of the actual services performed by the beneficiary for purposes of determining countable earnings before applying the SGA earnings guidelines.
B. Documentation and evaluation
1. Description of military work activities
The service member is the primary source of information about the work activities he or she performs. Documentation will help to resolve the extent of any subsidy in the military service pay and the actual worth of the limited duties.
If, however, the service member's description of duties is equivocal or apparently inaccurate, or if it shows activities not readily correlated to jobs in the civilian community, corroborative information is necessary. Military personnel having supervisory and administrative knowledge of the details and status of the limited work should be contacted. Examples of such personnel could include commanding officers or senior non-commissioned officers (for enlisted personnel).
2. Comparison of military and civilian work activities
a. Comparison based on first-hand knowledge
In some situations the service member's description of job duties may offer reasonable assurance that the work activity can be readily identified and compared to a similar type of civilian occupation, such as clerk-typist, truck mechanic, or the like. The adjudicator may be sufficiently aware of prevailing work and pay scales in the community to be able to equate the service member's job duties with those in the nonmilitary economy and to determine the worth of the services performed. In appropriate situations the file should reflect the details of such knowledge, inasmuch as the SGA determination must be made on the basis of what the service member does and how much such activity would be worth in the civilian community.
b. Comparison based on military occupation manuals
If no obvious comparison can be made between the service member’s military work duties and a civilian occupation, it may be necessary to consult the military occupation manuals. These manuals are published by each branch of military service and provide a classification system for all military service occupations for enlisted personnel, commissioned officers, and warrant officers. They describe the duties and personnel qualifications for each listed military occupation. For those occupations with a “direct, or reasonably related, civilian counterpart,” one or more “civilian source jobs” are listed according to the job code or title in the Department of Labor's
Dictionary of Occupational Titles (DOT). This correlation of military service occupations with civilian jobs classified in the DOT makes the military occupation manuals an indispensable reference source for comparing military and civilian work activities. The military occupational manuals are available through the officer in charge of personnel matters at military hospitals and installations and online at
[URL]http://www.careersinthemilitary.com/[/URL] . Click on “career exploration” then “alphabetical job list” for a specific job title that is cross-referenced by branch of service as well. Civilian counterpart jobs are listed here also.
Military reference materials should be used only when necessary for equating the job duties of service members with those performed in the civilian sector.
C. Comparison based on contact with other sources
Other steps may be indicated if reasonable doubt remains as to what represents an equivalent civilian job or as to how the value of the service member's work activities compares with the pay for similar civilian work. Contact may be made with employers, the U.S. Employment Service, or other informed sources of employment and vocational data, including a vocational specialist. These contacts are expected to be for advice and information gathering only, to aid judgments in the case. In some instances the military occupation manuals will not list, in conjunction with a military job, any related civilian job, or they may list only one civilian job which happens not to exist in the community in which the comparison is conducted. The title of the disabled service member's military service occupation and/or listed civilian job may, however, lead the vocational specialist to identify closely related civilian occupations discussed in the DOT with which the adjudicator may satisfactorily compare the military service occupation.
